Side Effect: Increased tear production (lacrimation)

Increased tear production, also known as hyperlacrimation or epiphora, refers to the excessive secretion of tears from the eyes. Common causes include eye irritation and allergies.

However, increased tear production can also occur if:

• the tears being produced don’t contain a key chemical needed to lubricate the eye
• if your eye is swollen due to an infection or from an injury
• if cancer treatment has caused the tear drainage ducts to become blocked.

The symptoms of increased tear production may include:

• watery eyes
• redness
• discomfort around the eyes

Cancer treatments that can cause increased tear production include:

• capecitabine and fluorouracil (5FU)
• imatinib
• ipilimumab
• panitumumab
• oxaliplatin
• cyclophosphamide
• methotrexate
• pemetrexed

• To help prevent increased tear production it is important to address any underlying eye conditions before starting treatment.
• It is also recommended that you wear sunglasses when outside.
• If you suffer from dust or pollen allergies using an air filter can be helpful.

The treatment for increased tear production depends upon the underlying cause.

• It may seem counterintuitive, but artificial tears and eye drops can help reduce the symptoms of increased tear production and provide relief as these will contain the lubrication that the eye may be craving.
• You should also avoid rubbing your eyes or wearing contacts. If a crust has built up due to the increased tearing, you can apply a warm compress to the eye to help gently wipe it away.

If increased tear production persists despite conservative treatment, there are several medical interventions that may be considered. These include: medications such as anticholinergics, botulinum toxin injections, or surgery to reposition the punctum or create a new drainage pathway.